BEND MEMORIAL CLINIC PC DBA SUMMIT HEALTH
NPI 1972144913
Clinical Medical Laboratory in Bend, OR
About Bend Memorial Clinic Pc Dba Summit Health NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BEND MEMORIAL CLINIC PC DBA SUMMIT HEALTH (NPI 1972144913) is a healthcare organization registered as a clinical medical laboratory in Bend, Oregon and active in the NPI registry since October 2019. The organization maintains 2 additional practice locations and lists Jessie Dover, Credentialing Coordinator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Locations 2
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bend Memorial Clinic Pc Dba Summit Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
315Medicare enrollment records show 315 clinicians reassign Medicare billing to Bend Memorial Clinic PC Dba Summit Health, which bills Medicare for the services they deliver. Of these, 127 practice at this address and 227 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 42
Nearest to this location (20)
See all 315Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Bend Memorial Clinic PC's NPI number?
The NPI number for Bend Memorial Clinic PC is 1972144913. It was assigned to this organization in the NPPES registry on October 1, 2019. The provider is doing business as Bend Memorial Clinic PC Dba Summit Health.
Where is Bend Memorial Clinic PC located?
Bend Memorial Clinic PC is located at 1501 NE Medical Center Dr, Bend, OR 97701. The listed phone number is (541) 382-2811.
What is Bend Memorial Clinic PC's specialty?
The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.
Is Bend Memorial Clinic PC enrolled in Medicare?
Yes. Bend Memorial Clinic PC is registered in the Medicare PECOS enrollment system.
When is Bend Memorial Clinic PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Oregon, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Bend Memorial Clinic PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 315 clinicians in 42 Medicare specialties reassign their Medicare billing to Bend Memorial Clinic PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (56), Diagnostic Radiology (55) and Family Practice (32). Of these, 127 practice at this address and 227 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Bend Memorial Clinic PC accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Bend Memorial Clinic PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Bend Memorial Clinic PC was last updated on April 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Bend Memorial Clinic Pc Dba Summit Health · NPI 1972144913
Clinical Medical Laboratory organization in Bend, Oregon. Organization record, active in the CMS NPPES registry since October 1, 2019.
## Identity
- **NPI:** 1972144913 (Entity type: Organization)
- **Enumerated:** October 1, 2019
- **Primary specialty:** Clinical Medical Laboratory · taxonomy 291U00000X
- **Legal business name:** Bend Memorial Clinic Pc
- **Organization subpart:** Yes (part of Bend Memorial Clinic Pc Dba Summit Health)
- **Authorized official:** Jessie Dover, CREDENTIALING COORDINATOR
## Practice location
- **Address:** 1501 NE MEDICAL CENTER DR, Bend, OR 97701-6051
- **Phone:** (541) 382-2811
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Oregon, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 315 clinicians in 42 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (56), Diagnostic Radiology (55), Family Practice (32); 127 practice at this address and 227 within 10 miles; [full list](https://npiprofile.com/npi/1972144913/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 14, 2023
- **Other identifiers:** Medicaid 213243 (OR)
---
Source: [NPI Profile](https://npiprofile.com/npi/1972144913) · Data from the CMS NPPES public registry.